Validation of the Persian Version of Critical Care Pain Observation Tool

Pain management is very important in patients in general intensive care units (G-ICU). Therefore, this study was conduct to investigate the validity and reliability of the Persian version of Critical Care Pain Observation Tool in patients admitted to this ward.

The present study is a methodological and clinimetery study that was conduct in inpatients in general intensive care units of Amol city during 2009-2010. The accordance between the two assessors was investigated using Lin’s Concordance correlation coefficient and the weighted kappa coefficient. The researcher evaluated Sixty-six patients in two positions of resting and painful action, using discriminant validity and the intended tool, to measure the validity of the tool.

The results showed the validity of the instrument through the validity of known groups, the score difference in the three indices of tool were meaningful (P<0.001). Also, the difference between the overall mean scores in the two positions of resting and rotation was meaningful, as well (P<0.001).  Reliability of the instrument through weighted kappa coefficient for quartet indices of the tool in the two resting and change position status varied between 0.38 and 0.60. The accordance between the two assessors in the overall score of the tool using Lin’s Concordance correlation coefficient was 0.68 in the resting position, 0.82 -0.47 in assurance interval, 0.67 in the rotation position in assurance interval, and 0.42 to 0.82 in assurance interval.

Although the Persian version of the CPOT could differentiate pain-causing situations from no pain-causing ones, but its rate was low. Besides, the accordance between the two assessors was weak to medium. Therefore, it is recommended to use it with more care and caution in different patients with different diagnoses; also, other criteria for pain in patients should not be ignored.